MEDICAL SCRIBES AS AN INPUT IN HEALTH-CARE PRODUCTION Evidence from a Randomized Experiment

被引:8
作者
Friedson, Andrew I. [1 ]
机构
[1] Univ Colorado, Dept Econ, Denver, CO 80202 USA
关键词
medical scribes; emergency rooms; health-care production; specialization of labor; INFORMATION-TECHNOLOGY; PATIENT; IMPACT;
D O I
10.1162/ajhe_a_00103
中图分类号
F [经济];
学科分类号
02 ;
摘要
Medical scribes are charting specialists who prepare patient charts in the physician's stead, creating efficiency gains in production via specialization of labor. The scribe industry has grown rapidly in recent years, but relatively little is known about its impact on health-care production. I use data from a randomized experiment in which scribes were assigned to some, but not all, physician shifts in three emergency rooms over nine months. Generally, I find that scribes significantly decrease physician overtime usage, increase the number of relative value units per shift, and decrease patient wait times. The size of the benefits of scribes varies considerably based on the types of shifts worked and characteristics of the physician matched with the scribe.
引用
收藏
页码:479 / 503
页数:25
相关论文
共 38 条
[1]   The effects of health information technology on the costs and quality of medical care [J].
Agha, Leila .
JOURNAL OF HEALTH ECONOMICS, 2014, 34 :19-30
[2]  
[Anonymous], 2013, NBER DIGEST
[3]   Impact of Scribes on Performance Indicators in the Emergency Department [J].
Arya, Rajiv ;
Salovich, Danielle M. ;
Ohman-Strickland, Pamela ;
Merlin, Mark A. .
ACADEMIC EMERGENCY MEDICINE, 2010, 17 (05) :490-494
[4]   Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a prospective study [J].
Bank, Alan J. ;
Obetz, Christopher ;
Konrardy, Ann ;
Khan, Akbar ;
Pillai, Kamalesh M. ;
McKinley, Benjamin J. ;
Gage, Ryan M. ;
Turnbull, Mark A. ;
Kenney, William O. .
CLINICOECONOMICS AND OUTCOMES RESEARCH, 2013, 5 :399-406
[5]   The financial burden of emergency department congestion and hospital crowding for chest pain patients awaiting admission [J].
Bayley, MD ;
Schwartz, JS ;
Shofer, FS ;
Weiner, M ;
Sites, FD ;
Traber, KB ;
Hollander, JE .
ANNALS OF EMERGENCY MEDICINE, 2005, 45 (02) :110-117
[6]  
Becker G., 1994, HUMAN CAPITAL THEORE, V3rd, P299
[7]   PRODUCTION OF HUMAN CAPITAL AND LIFE CYCLE OF EARNINGS [J].
BENPORATH, Y .
JOURNAL OF POLITICAL ECONOMY, 1967, 75 (04) :352-365
[8]   The Effect of Emergency Department Crowding on Clinically Oriented Outcomes [J].
Bernstein, Steven L. ;
Aronsky, Dominik ;
Duseja, Reena ;
Epstein, Stephen ;
Handel, Dan ;
Hwang, Ula ;
McCarthy, Melissa ;
McConnell, K. John ;
Pines, Jesse M. ;
Rathlev, Niels ;
Schafermeyer, Robert ;
Zwemer, Frank ;
Schull, Michael ;
Asplin, Brent R. .
ACADEMIC EMERGENCY MEDICINE, 2009, 16 (01) :1-10
[9]   The division of labour, worker organisation, and technological change [J].
Borghans, L ;
ter Weel, B .
ECONOMIC JOURNAL, 2006, 116 (509) :F45-F72
[10]   Measuring the cost impact of hospital information systems: 1987-1994 [J].
Borzekowski, Ron .
JOURNAL OF HEALTH ECONOMICS, 2009, 28 (05) :938-949